Colas Tcherakian

Curing HIV-associated pulmonary arterial hypertension

To the Editors: Pulmonary arterial hypertension (PAH) results from chronic obstruction of small pulmonary arteries, leading to right ventricular failure and ultimately death. PAH is a severe complication, known to be related to HIV infection [1]. The frequency of PAH in HIV patients is strikingly higher than in the general population and the fourth-leading cause of PAH in the French registry [2]. The incidence of PAH related to HIV (PAH-HIV) has not decreased over time, despite efficient anti-retroviral therapy (ART) [3]. Since its description in 1987, PAH-HIV has been well characterised and multiple therapeutic strategies have been proposed, but no full recovery has yet been published. Here, …

Malformation kystique adénomatoïde pulmonaire de l’adulte : une pathologie méconnue

Currently, most congenital lower respiratory tract malformations are detected during pregnancy or at birth, thanks to antenatal imaging. However, a pulmonary congenital cystic adenomatoid disease may be found in adulthood. The diagnosis is difficult, due to its rarity. We present the case of a patient whose diagnosis of pulmonary cystic adenomatoid malformation was confirmed when she had tuberculosis. A lobectomy was performed, which enabled identification of tuberculosis and also multiple cysts of adenomatoid malformation. The risk posed by this malformation, i.e. the risk of developing bronchioloalveolar carcinoma and of infection or pneumothorax, is the incentive for proposing formal surgical removal.

La recherche d’une étiologie est-elle nécessaire à la prise en charge d’un adulte ayant une dilatation des bronches ?

Bronchiectasis may result from various causes. Recognition of these underlying causes may lead to specific management. Focal bronchiectasis are related to luminal blockage or extrinsic narrowing. The causative factors of diffuse bronchiectasis may be suggested by the predominant distribution of the disease and associated extrapulmonary manifestations. Primary immunodeficiencies cystic fibrosis, allergic bronchopulmonary aspergillosis, chronic Mycobacterium avium complex infection, and systemic diseases have to be looked for, even in patients with knowledge of a childhood respiratory infection.